Scholarship Form

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If you prefer to print and mail your application please make sure that the application is received at least one week before the start of the class that you would like to attend. Download here.

Scholarship Application

Application to apply for scholarship

Mercy Corps Northwest requires proof of a student’s gross annual household income in order to award
scholarships for course fees. Please provide us with all relevant items as available to document each source
of household income. (A household being all persons who live together and/or share finances. Household
size includes dependents and spouses. If spouse generates income, this must be documented also.)

If you are currently employed… the most current pay stub which indicates your gross amount of
pay (either dollar amount per pay period or hourly rate) the number of hours you work per pay period, and how often you are paid.

If you are self-employed… the most current income tax return

If you are retired… the most current amounts you are receiving as indicated on Social Security
statement, 1099, or other document

If you are receiving assistance… whether it is your primary source of income or in addition to your income, from agencies such as SSI, Disability, Unemployment Compensation, Social Security, etc., or receiving income from other sources such as child support, we need documentation reflecting the most current amounts you are receiving and the providing agency

If you are unemployed and not receiving any form of income or assistance… please provide us with a letter explaining your situation and the need for scholarship assistance

Type your name here.

I agree to provide Mercy Corps Northwest with all amounts of household income in order to be
considered for a scholarship. I certify the information will be current and accurate.